Breast cancer is the most commonly occurring cancer in women, with nearly a quarter of a million cases diagnosed annually, according to the U.S. Centers for Disease Control and Prevention. Every day, 112 women lose their lives to breast cancer.
Although the incidence of breast cancer has leveled off in the general population, it has increased in two ethnic groups: black women and Pacific Islanders. While breast cancer is the No. 2 cause of death among women in the U.S., it is the No. 1 cause of death among women of Hispanic descent. It is unclear why this is so, but genetics, access to care and lifestyle factors may play a role.
Nonetheless, every October, emphasis is placed upon the importance of screening mammography in the early detection of breast cancer. Entire towns are “painted pink” to raise awareness of breast cancer and as a reminder to “get your mammogram.” It is an important message, not only in October but year-round, as early detection presents the best opportunity for successful treatment and survivorship.
Over the past two decades, there has been significant progress in the technology used to detect breast cancer. Screening mammography is widely hailed as having a significant impact in the fight against breast cancer. Additional imaging modalities have been introduced to the general public in the past 10 – 20 years include digital mammography, breast MRI, breast ultrasound, contrast-enhanced mammography and 3D mammography.
Lexington Clinic Center for Breast Care offers 3D mammography to all women and is the first facility in Central Kentucky to offer contrast-enhanced mammography. This is a promising new technology for diagnosing breast cancer, especially in women with dense breast tissue and those with a family history of breast cancer.
Technically called tomosynthesis, 3D mammography uses advanced computer modeling to create a three-dimensional image of each breast. During this type of mammogram, the equipment rotates around the breast, capturing a series of images. The data is reconstructed into high resolution “slices” to allow the radiologist to view layers of breast tissue. This breakthrough in technology improves sensitivity and reduces false positives. This means that cancers are detected earlier and fewer women are called back for additional views of areas that end up being normal tissue.
“With traditional two-dimensional mammography, tumors and other abnormalities can sometimes be hidden by overlapping normal tissue,” said Chad Harston, M.D., a board-certified radiologist at Lexington Clinic who specializes in women’s imaging. “This can be especially problematic for women who have dense breast tissue or cysts,” Harston said.
“Lexington Clinic is one of the few breast imaging centers that offers three-dimensional mammography without increasing radiation exposure,” Harston noted. “Our technology allows us to create 3D and 2D images simultaneously, which keeps radiation doses low.”
Contrast-enhanced spectral mammography
Contrast-enhanced spectral mammography (CESM) is a promising new test with significantly improved sensitivity for breast cancer. The testing procedure is similar to a routine mammogram except that in a contrast-enhanced mammogram, the patient receives an intravenous injection of iodine-based contrast material before images are obtained. The contrast accumulates in malignant lesions faster than normal tissue. This makes it possible to detect cancers that may otherwise be obscured in women with dense breasts. About 50% of women who are eligible for screening mammography have dense breast tissue and would benefit from this test.
Two sets of images are obtained almost simultaneously during a contrast-enhanced mammography exam, one is a normal mammogram and the other is a CESM image. These two images work together to help providers pinpoint any areas with abnormalities.
“In the past, women with dense breast tissue were at a significant disadvantage.” Dr. Harston noted. “The main weakness of traditional mammograms is that it relies on simple black and white contrast. Fatty tissue is black and glandular tissue is white. However, breast cancer also appears white on mammograms. So with a traditional mammogram, looking for a cancer in dense tissue is like looking for a polar bear in a snowstorm. Dense glandular tissue can completely obscure some tumors because both appear white on mammograms. About 70 percent of missed cancers occur in women with dense tissue.”
Dr. Harston continued, “We can now offer contrast-enhanced mammography to these women. This test has significantly improved sensitivity – in fact, the sensitivity is similar to MRI, but at a fraction of the cost.”
Both 3D mammography and CESM have been found to:
• Detect smaller tumors that may have been hidden during two-dimensional mammography
• Increase accuracy in pinpointing the size, shape and location of a tumor or abnormality
• Reduce the need for biopsy and/or additional imaging in women who do not have cancer
Lexington Clinic provides mammography and screening mammography services at Lexington Clinic South Broadway, Lexington Clinic East and Jessamine Medical and Diagnostic Center. Advanced breast health services including 3D mammography and contrast-enhanced mammography are provided at the Center for Breast Care on South Broadway.
For more information or to schedule a mammogram, please call (859) 258-4444.
Breast Care Services at Lexington Clinic
The Center for Breast Care at Lexington Clinic uses a collaborative and multidisciplinary approach to breast care. Our comprehensive team of radiologists, pathologists, surgeons, medical and radiation oncologists work alongside a fellowship-trained mammographer to create a customized treatment plan tailored to your specific needs. Our breast care team provides breast biopsies, MRIs and ultrasounds and assessments for breast cancer risks. Flexible appointment times, convenient locations and an experienced, professional staff guarantee you will receive the highest quality of care you deserve in a compassionate setting.
• Breast MRI*
• Breast Ultrasound*
• Clinical Counseling
• Digital Mammography*
• Diagnostic Mammography
• Screening Mammography
• High Risk Assessment for Breast Cancer
• MRI Guided Breast Biopsy*
• Needle Localization
• Sentinel Node Biopsy
• Sterotactic Breast Biopsy*
• Ultrasound Guided Breast Biopsy*
• Ultrasound Guided Breast Cyst Aspiration*
* – Accredited by the American College of Radiology (ACR)